The effectiveness of post-operative rehabilitation following partial meniscectomy of the knee

Background: Injuries to the menisci of the knee are a common cause of impairment and functional disability. The prevalence of meniscal injury ranges from 19 to 56% depending on the population studied. Arthroscopic surgery to the meniscus may be required if conservative care has failed. There is still controversy as to the need for routine post-operative rehabilitation to improve function and reduce impairments. Objectives: The purpose of this paper was to systematically review the literature that evaluated the effectiveness of post-operative exercise programmes to improve function and reduce impairments following partial meniscectomy of the knee. Methods: A computerized electronic search was performed across seven databases to locate relevant studies. Inclusion criteria consisted of studies that were randomized controlled trials, published in English, in patients who were prescribed exercise programmes and where function and impairment measures after knee arthroscopy were measured. The PEDro tool was used to rate the methodological quality of the studies. Four reviewers independently reviewed the studies. Results: The database search revealed 319 studies. Twelve studies met the inclusion criteria. The methodological quality of the studies indicated that the level of evidence was limited. There were consistent methodological flaws in assessor blinding, treatment delivery and participant blinding. Significant variation across the interventions in a range of parameters was observed. Conclusions: There is limited evidence of low to moderate quality for the effectiveness of exercise rehabilitation following partial meniscectomy. Supervised clinic and structured home based programmes are equally effective. Future studies need to address the consistency of exercise interventions and functional outcome measurements and follow-up time frames.